Resources Repository
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ArticlePublication 2017When Cost-Effective Interventions Are Unaffordable
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, …
Many health interventions deemed cost-effective are not affordable. Despite the importance of affordability to policymakers, little of the cost-effectiveness literature in global health addresses this issue. Budget impact analysis (BIA) describes an intervention's short-term costs and savings from the payer's perspective. This paper assesses the current use of budget impact analysis (BIA) and cost-effectiveness analysis (CEA) in health economic assessments conducted for low- and middle-income countries (LMICs). The authors recommend steps researchers and policymakers can…
Global | Priority Setting/Ethics | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Government/Law | Health/Medicine | Science/Technology -
ArticlePublication 2017Using Cost-Effectiveness Analysis to Address Health Equity Concerns
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity …
This article serves as a guide to using cost-effectiveness analysis (CEA) to address health equity concerns. The authors introduce the "equity impact plane," a tool for considering trade-offs between improving total health-the objective underpinning conventional CEA-and equity objectives, such as reducing social inequality in health or prioritizing the severely ill. Improving total health may clash with reducing social inequality in health, for example, when effective delivery of services to disadvantaged communities requires additional costs. Who…
Global | Preferences/Values | Priority Setting/Ethics | Cost-Effectiveness Analysis | Health Systems | Policy/Regulation | Health/Medicine -
ArticlePublication 2017Cost-Effectiveness of a Policy Strategy to Decrease Sodium Intake: Global Analysis
The objective of this study was to assess the cost effectiveness of a government policy combining …
The objective of this study was to assess the cost effectiveness of a government policy combining targeted industry agreements and public education to reduce sodium intake in 183 countries worldwide. To account for heterogeneity in efficacy across countries, a range of scenarios were evaluated, including 10%, 30%, 0.5 g/day, and 1.5 g/day sodium reductions achieved over 10 years. Country specific costs of a sodium reduction policy were estimated using the WHO Noncommunicable Disease Costing Tool. Country…
Global | Cost-Effectiveness Analysis | Child/Nutrition | Chronic Disease/Risk | Social Determinants | Policy/Regulation | Food/Agriculture | Government/Law | Health/Medicine -
ArticlePublication 2016Reproductive, Maternal, Newborn, and Child Health: Key Messages from DCP3
As part of the Disease Control Priorities, Third Edition, the World Bank has published a …
As part of the Disease Control Priorities, Third Edition, the World Bank has published a volume on Reproductive, Maternal, Newborn and Child Health that identifies essential cost-effective health interventions that can be scaled-up now to reduce maternal, newborn and child deaths, and stillbirths. This article summarizes the key findings and estimates the impact and cost of expanded implementation of these interventions. Scaling up all preventive and therapeutic health interventions in these integrated packages from current…
Global | Costing Methods | Cost-Effectiveness Analysis | Maternal/Reproductive Health | Child/Nutrition | Health Systems | Health/Medicine -
ArticlePublication 2016Essential Package of Cancer Control: Costs, Affordability, and Feasibility of an Essential Package of Cancer Control Interventions in LMIC Countries
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in …
Investments in cancer control-prevention, detection, diagnosis, surgery, palliative care-are needed in low-income and particularly in middle-income countries, where most of the world's cancer deaths occur without treatment or palliation. To help countries expand locally appropriate services, Disease Control Priorities, 3rd edition developed an essential package of potentially cost-effective measures for countries to consider and adapt. Interventions included in the package are: prevention of tobacco-related cancer and virus-related liver and cervical cancers; diagnosis and treatment of…
Global | Costing Methods | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology -
ArticlePublication 2016UHC for Mental, Neurological, and Substance Use Disorders: An Extended CEA
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public …
This study uses extended cost effectiveness analysis (ECEA) to analyze the impacts of universal public finance (UPF) on epilepsy, schizophrenia, and depression in India and Ethiopia. The Ethiopian government has launched a National Mental Health Strategy which explicitly recognizes the importance of an efficient, equitable scale-up of mental health care within a broader, ongoing effort to increase levels of health insurance in the general population. The analyses show that enhanced coverage of effective treatment leads…
Global | Priority Setting/Ethics | Cost-Effectiveness Analysis | Mental Health | Social Determinants | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2016Using Top-Down and Bottom-Up Costing Approaches in LMICs
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel …
In the absence of routine cost data collection, estimating the incremental costs of scaling-up novel technologies in low-income and middle-income countries is a methodologically challenging and substantial empirical undertaking. Using the example of costing the scale-up of Xpert Mycobacterium tuberculosis (MTB)/resistance to riframpicin (RIF) in South Africa, the authors estimate costs, by applying two distinct approaches of bottom-up and top-down costing, together with an assessment of processes and capacity. The unit costs measured using the…
Global | Costing Methods | Cost-Effectiveness Analysis | Infectious Diseases | Health Systems | Economics/Finance | Health/Medicine -
ArticlePublication 2016Accounting for Technical, Ethical, and Political Factors in Priority Setting
This article investigates two cases of priority setting to explore how, in addition to technical …
This article investigates two cases of priority setting to explore how, in addition to technical considerations, ethical and political factors shape the allocation of health resources. First, they discuss how Thai authorities adjudicated a coverage decision for HLA-B*1502 screening, which meets the national cost-effectiveness threshold for only some of the conditions it can detect. Second, they consider England’s Cancer Drugs Fund to investigate the interplay of technical decision making and political reality. The findings suggest four concluding…
Global | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Policy/Regulation | Climate/Environment | Government/Law | Health/Medicine | Science/Technology | Europe -
ArticlePublication 2016Using Cost-Effectiveness Evidence to Inform Health Service Provision
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer …
This article discusses three challenges of using cost-effectiveness thresholds to inform whether a third-party payer will fund a particular service. First, how is the appropriate cost-effectiveness threshold - or threshold range - to be determined? (And should there be a single threshold or multiple thresholds?) Second, how can the valuation of health benefits be refined to better capture the value of treatments to patients and to the economy as a whole? Third, how should a…
Global | Priority Setting/Ethics | Evidence Synthesis | Cost-Effectiveness Analysis | Policy/Regulation | Health/Medicine